Encapsulating Peritoneal Sclerosis in a kidney transplant recipient - Case Report

Area of Science:

• Nephrology
• Gastroenterology
• Surgical Pathology

Background:

• Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of peritoneal dialysis (PD), often leading to bowel obstruction and significant mortality.
• The condition involves fibrous tissue encapsulation of visceral organs, impairing digestive function.
• Focal segmental glomerulosclerosis (FSGS) is a potential underlying cause of chronic kidney disease necessitating PD.

Observation:

• A patient with FSGS-induced chronic kidney disease on PD developed EPS after two kidney transplants.
• The patient presented with symptoms of bowel obstruction.
• The case involved complex surgical interventions and clinical management.

Findings:

• Surgical techniques and clinical measures were employed to alleviate bowel obstruction.
• Parenteral nutrition was crucial for providing adequate nutrition, enhancing tissue healing, and normalizing serum levels of proteins, vitamins, and electrolytes.
• Treatment with tamoxifen and sodium thiosulfate demonstrated efficacy in delaying the progression of EPS.

Implications:

• This case illustrates that a multidisciplinary approach can effectively manage EPS complications in PD patients.
• Parenteral nutrition plays a vital role in recovery and preventing further complications.
• Pharmacological interventions like tamoxifen and sodium thiosulfate show promise in managing EPS.
• Successful management can improve patient outcomes and quality of life despite the severity of EPS.